發(fā)布時(shí)間：2017-12-31 00:39

  本文關(guān)鍵詞：早產(chǎn)兒呼吸暫停高危因素的臨床研究　出處：《泰山醫(yī)學(xué)院》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 早產(chǎn)兒 呼吸暫停 高危因素

【摘要】：目的 探討導(dǎo)致早產(chǎn)兒呼吸暫停（Apnea of premature, AOP）發(fā)作的常見因素，分析最終引起該病的危險(xiǎn)因素，對(duì)其高度重視，提前預(yù)防及采取措施，提高防治水平，減少或避免并發(fā)癥。 方法 收集中國(guó)人民解放軍第88醫(yī)院新生兒科2011年1月～2012年12月及中國(guó)人民解放軍八一兒童醫(yī)院2012年3月～6月收治的呼吸暫停早產(chǎn)兒103例，及同期住院的非呼吸暫停早產(chǎn)兒103例作為臨床資料。呼吸暫停組為病例組，非呼吸暫停為對(duì)照組。對(duì)患兒的胎齡、出生體重等22種因素進(jìn)行回顧性分析，然后予以統(tǒng)計(jì)學(xué)處理。 結(jié)果 1.本研究103例AOP患兒，，原發(fā)性呼吸暫停40例，發(fā)生率為38.8%，繼發(fā)性呼吸暫停63例，發(fā)生率為61.2%。呼吸暫停在病程早期發(fā)生率較高，其中12小時(shí)內(nèi)AOP共47例，發(fā)生率為45.63%；12小時(shí)～2天AOP共36例，發(fā)生率為35%；2天～5天AOP共12例，占11.7%，原發(fā)性呼吸暫停5天內(nèi)發(fā)生率較高，繼發(fā)性呼吸暫�？砂l(fā)生在病程任何階段。 2.出生體重越小，胎齡越小，呼吸暫停發(fā)生率越高，尤其是原發(fā)性呼吸暫停，繼發(fā)性呼吸暫停發(fā)生率較原發(fā)性呼吸暫停低。AOP組中，感染性疾病共28例，發(fā)生率為27.2%，早產(chǎn)兒中樞神經(jīng)系統(tǒng)疾病共41例，發(fā)生率為39.8%；新生兒呼吸窘迫綜合征（Neonatal respiratory distress syndrome, NRDS）21例，發(fā)生率為13.1%，代謝性紊亂50例，占48.5%。 3.通過對(duì)兩組103例AOP及非AOP分析，22種因素進(jìn)行組間比較：胎齡小于33周、出生體重＜1500克、新生兒肺炎、酸中毒、呼吸窘迫綜合征、顱內(nèi)出血、貧血、缺氧缺血性腦�。℉ypoxic ischemic encephalopathy, HIE）、胎糞吸入綜合征、低鈣血癥共8種高危因素，P值＜0.05。 4.經(jīng)高危因素的單因素Logistic回歸分析：胎齡小于33周、出生體重＜1500克、酸中毒是AOP的高危因素。P值均小于0.05。 結(jié)論 1.呼吸暫停與出生體重、胎齡有關(guān)：出生體重越小，胎齡越小，呼吸暫停發(fā)生率越高，而且原發(fā)性呼吸暫停發(fā)生率亦越高，繼發(fā)性呼吸暫停隨體重胎齡變化無明顯規(guī)律。 2.呼吸暫停與出生后時(shí)間有關(guān)：呼吸暫停病程早期發(fā)生率較高，原發(fā)性呼吸暫停5天內(nèi)發(fā)生率較高，繼發(fā)性呼吸暫�？砂l(fā)生在病程任何階段。 3.胎齡小于33周、出生體重＜1500克、酸中毒是早產(chǎn)兒AOP發(fā)病的獨(dú)立高危因素。
[Abstract]:Purpose To investigate the common factors leading to apnea of apnea of preterm infants (AOPs), and to analyze the risk factors leading to the disease, and to attach great importance to it. Preventive measures should be taken in advance to improve the level of prevention and treatment and to reduce or avoid complications. Method The paediatrics of the 88th Hospital of the Chinese people's Liberation Army (PLA) from January 2011 to December 2012 and the Bayi Children's Hospital of the Chinese people's Liberation Army (PLA) from March 2012 to March 2012 were collected. 03 cases. The clinical data were 103 cases of non-apnea premature infants in the same period. The apnea group was the case group and the non-apnea group was the control group. 22 factors, such as gestational age, birth weight and so on, were analyzed retrospectively. They are then treated statistically. Results 1. There were 40 patients with primary apnea (38.8%) and 63 cases with secondary apnea (63 cases) in this study. The incidence of apnea was higher in the early stage of the disease, including 47 cases of AOP within 12 hours (45.63%). There were 36 cases of AOP in 12 hours and 2 days, the incidence rate was 35%. There were 12 cases of AOP in 2 days and 5 days, accounting for 11. 7%. The incidence of primary apnea was higher within 5 days. Secondary apnea could occur at any stage of the course of disease. 2. The lower the birth weight and the smaller the gestational age, the higher the incidence of apnea, especially in the primary apnea group, the secondary apnea rate was lower than that in the primary apnea group. There were 28 cases of infectious diseases, the incidence rate was 27.2%, and 41 cases of central nervous system diseases of premature infants, the incidence rate was 39.8%. The incidence of Neonatal respiratory distress syndrome (NRDS)21) was 13.1%. Metabolic disorders were found in 50 cases (48.5%). 3. 22 factors of AOP and non AOP analysis were compared between the two groups: gestational age was less than 33 weeks, birth weight was less than 1500g, neonatal pneumonia, acidosis. Respiratory distress syndrome, intracranial hemorrhage, anemia, Hypoxic ischemic encephalopathy, HIE, meconium aspiration syndrome. There were 8 high risk factors in hypocalcemia (P < 0.05). 4. Univariate Logistic regression analysis of high risk factors: gestational age < 33 weeks, birth weight < 1500g, acidosis is the high risk factor of AOP, P < 0.05. Conclusion 1. Apnea is related to birth weight and gestational age: the smaller the birth weight, the smaller the gestational age, the higher the incidence of apnea and the higher the incidence of primary apnea. There was no obvious change of secondary apnea with body weight and gestational age. 2.Respiratory apnea is related to postnatal time: the incidence of early stage of apnea is higher than that of primary apnea within 5 days. Secondary apnea can occur at any stage of the disease course. 3. Gestational age < 33 weeks, birth weight < 1500g, acidosis is an independent risk factor for preterm infants with AOP.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R722.6

【共引文獻(xiàn)】

相關(guān)期刊論文 前4條

1 顧松;王亞娟;楊彩云;王慧欣;楊學(xué)芳;邵芳;齊宇潔;林影;;新生兒呼吸暫停328例臨床分析[J];山東醫(yī)藥;2013年28期

2 李茂軍;陳昌輝;;支氣管肺發(fā)育不良的研究進(jìn)展[J];實(shí)用醫(yī)院臨床雜志;2013年04期

3 劉林霞;張玉俠;;早產(chǎn)兒呼吸暫停非藥物干預(yù)的研究進(jìn)展[J];中華護(hù)理雜志;2014年01期

4 王丹靜;楊麗琛;;綜合舒適護(hù)理預(yù)防早產(chǎn)兒喂養(yǎng)不耐受的臨床觀察[J];中國(guó)現(xiàn)代醫(yī)生;2013年31期

相關(guān)碩士學(xué)位論文 前2條

1 倪映華;茶堿治療早產(chǎn)兒呼吸暫停的療效研究[D];浙江大學(xué);2010年

2 李茂軍;阿奇霉素防治早產(chǎn)兒支氣管肺發(fā)育不良的系統(tǒng)評(píng)價(jià)[D];瀘州醫(yī)學(xué)院;2013年

本文編號(hào)：1357283